You and your baby

Uninterrupted skin-to-skin contact between mother and baby after birth is precious and is encouraged for all mothers, even those not intending to breastfeed. Holding your baby skin-to-skin helps you to bond closely with your baby. This is linked to better breastfeeding success and longer breastfeeding duration. We will help you recognise the signs that your baby is ready to feed such as licking, sucking, putting his/her hand to her mouth, and making soft noises. Immediate skin-to-skin contact helps populate your baby’s microbiome with the micro-organisms of the mother’s skin, leading to better gut health in baby. Baby’s temperature, heart rate, blood pressure and blood sugar levels are more stable, reducing stress levels in baby. After a caesarean birth, it is usual practice to have your baby with you in recovery whenever possible. Please talk to your midwife about this.

Before the birth of your baby, it is important that you understand the security procedures we have in place at the Lyell McEwin Hospital to ensure your baby’s safety. All measures are taken to ensure the safety of you and your baby while you are in hospital. However, you play the most important role in ensuring your baby’s safety. In most ward areas, doors are locked, entry is gained via intercom, and closed-circuit television is used to monitor visitor access.

Identification bands

We use three-part name tags for identification purposes. Two of these bands will be placed on your baby as soon as possible after birth, one on each ankle. These ID bands contain matching numbers, and mothers will be given a wrist band with the same number as their baby.

One of your baby’s identification bands will also contain a Halo tag. This will set off an alarm if your baby leaves the ward while wearing it. If your baby’s identification bands become loose, it is vital that you ask the midwives to replace them as soon as possible.

Some babies who are cared for in the Special Care Nursery will not be given a Halo tag, however they will still have the identification bands with matching numbers. Each baby’s footprints are taken for identification purposes and kept in their medical records.

Leaving your baby unattended

Whenever possible, please keep your baby where you can see him or her. When using the bathroom, you may choose to shut the door to your room and leave the bathroom door open so that you can continue to monitor your baby. If this is not practical, or if you need to leave your room, please take your baby, in their cot, to the Women’s Health Nursery and notify a midwife before you leave. When you are sleeping, keep your baby’s cot on the side of your bed that is furthest away from the door, if practical.

Transporting your baby

Our staff will always transport your baby in their cot. Please ring for urgent assistance if anyone carries your baby out of the room in their arms. We ask that during your stay in hospital, always move your baby around in his or her cot. For security reasons, staff may assume you are an unauthorised person if you are seen carrying a baby from one room to another in your arms. Carrying your baby in your arms can also be risky if you happen to slip.

Monitoring visitors

While trying to provide a warm and welcoming environment for your family and friends, we also try to ensure that we monitor visitors on the wards. The maternity unit is under constant video surveillance and doors to ward areas are locked.

Staff who care for your baby

Any staff member who is responsible for transporting your baby from one area to another will have a different form of identification. Please ask the staff what this is when you are admitted, and please do not hesitate to ask any staff member if you would like to see their identification badge.

If someone offers to watch over your baby for you, please ensure that you check their identification first.

Several routine health checks are recommended for babies in the first few weeks of life.

Newborn health check

Your baby will be carefully examined by a doctor or midwife soon after birth. We also recommend you visit your GP for a well-baby check when your baby is two weeks old and again at six weeks old.

Hearing screening

The newborn hearing screen is offered to all new parents free of charge. Two in every thousand babies will experience hearing loss. A simple hearing screen can help to identify this soon after birth.

Early identification is vital, especially for a child’s speech and language development.

It is important to screen all babies even if there is no family history of hearing impairments.

Having the screening test done is not painful for your baby. It is usually done while your baby is resting quietly or asleep and most babies remain asleep through the screening process. It only takes a few minutes, and you can stay with your baby while it is being done.

The midwife or designated screener will place a headphone over the outer part of your baby’s ear and small sensors around your baby’s ear and head. The machine sends a clicking sound down the ear canal and the sensors detect how the hearing nerve responds to those sounds.

If your baby has a ‘pass’ result from the hearing screen

The results of a hearing screen give a good indication of your baby’s hearing at the time of the screen. However, it is possible for a child to develop hearing loss later due to middle ear infection, inherited conditions, family history of hearing loss, or other infections and illnesses.

If your baby is at risk of developing hearing loss, it may be recommended that he or she has a hearing test with an audiologist around their first birthday.

If your baby has a ‘refer’ result from the hearing screen

Your baby may refer on the first newborn hearing screen because:

• Your baby’s ears were still too moist to respond to the screening – it can take a few days for this moisture to dry.
• Some matter entered the ear canal during birth – this is common and it will clear with time.
• Your baby may have a hearing loss.

Your baby’s second hearing screen will be followed up in the community by the CaFHS nurse.

What if my baby does not receive a hearing screening prior to discharge?

Your baby may miss receiving a newborn hearing screen before you are discharged. If this happens, the hospital will give your details to CaFHS, who will then contact you to make an appointment within four weeks of discharge.

If they do not contact you, please ring CaFHS on 1300 733 606.

For more information Newborn hearing assessment.  

Newborn screening test

Screening newborn babies to identify certain diseases is an established worldwide public health practice. The newborn screening test is performed using a small sample of blood collected by a midwife when the baby is about two days of age. From this sample, several tests are performed to detect rare but serious health disorders before there is any sign that the disorder exists.

Early diagnosis and appropriate treatment can greatly reduce and often prevent the effects of the disorder for the rest of the individual’s life.

To collect the sample, the baby’s heel is pricked, and a small piece of special filter paper is soaked with four small spots of blood and allowed to dry. The blood spot sample card is sent to the SA Neonatal Screening Centre at the Women’s and Children’s Hospital for testing.

Some health problems that can be detected using these blood spots include:

• Cystic fibrosis (CF)
• Congenital hypothyroidism
• Phenylketonuria (PKU)
• Galactosaemia
• Several conditions affecting the breakdown of fats (fatty acid oxidation defects – FAOD) and proteins (amino acid metabolism disorders)

Results

Test results are sent to the hospital or midwife within a week. If the results are normal you will not be notified. Occasionally, a repeat specimen may be required because of poor sample collection or a slightly elevated result. Results of repeat testing will also be sent back to your doctor or midwife.

Why we test

Screening is valuable because it leads to early treatment, reducing or avoiding permanent long-term health effects. Our aim is to detect infants at increased risk of any of these conditions who need more precise and specialised diagnostic testing.

For more information Newborn bloodspot screening.

To reduce the risk of Sudden Infant Death Syndrome (SIDS), the Lyell McEwin Hospital recommends babies are settled according to the South Australian Safe Infant Sleep Standards.

Whenever you put your baby down to sleep, make sure they:

• Are sleeping on their back on a firm, clean, flat, well-fitted mattress.
• Have their head and face uncovered at all times.
• Have their feet at the foot of the cot.
• Are dressed for the season to provide warmth, but avoid overheating.
• Have all bedclothes or blankets tucked in firmly.

For daytime and night-time sleeps, always ensure your baby sleeps on their own sleep surface in a cot. Babies should never be left sleeping alone on couches, bean bags or rockers.

It is very important that your baby is in a smoke-free environment at all times and that you never let anybody smoke near your baby. Follow these guidelines for all babies up to 12 months of age.

The information above is only a brief summary and does not include the important issues of safe wrapping and tummy time.

For more information Safe sleep and safer pregnancy, newborn to 1 year. 

When travelling in a motor vehicle in South Australia, by law all children under 16 years of age must be restrained in a suitable approved restraint that is properly adjusted and fastened. It is the responsibility of parents to have a suitable car seat or capsule fitted and checked by a qualified person, and we suggest that this is done by about 35 weeks into the pregnancy at the latest.

Children under 6 months of age must use an approved:

• Rearward facing child car restraint with an inbuilt harness
• Properly fitted to the vehicle
• Adjusted to fit the child’s body correctly
• Children under 6 months of age are not permitted in the front seat of a vehicle that has two or more rows of seats

It is recommended to keep your baby in a rearward facing child car restraint until they outgrow it. This will be when they have reached the maximum size limits (length and weight).

Transporting premature and low birth weight babies

Premature and low birth weight babies do not fit well in standard car seats and carriers and should be travelling in the Britax Unity Carrier Isofix, which is currently the only baby capsule in Australia suitable for low birth weight and premature infants.

Child car restraint fitting and support for families

Kidsafe SA operates the only comprehensive ongoing child car restraint fitting, checking, hiring, training and advisory service in South Australia. Kidsafe SA also runs free newborn safety information sessions.

For more information on child passenger requirements or services, contact your local Kidsafe state or territory office. You can also call (08) 7089 8554 (select option 1 for Road Service) or email enquiries@kidsafesa.com.au.

Keep your baby cool and protect them from the sun. Babies and young children can’t cool themselves as well as adults, so they’re more at risk of overheating and developing a heat-related illness.

The tips below will help keep your child happy and healthy in the heat:

• Babies less than 6 months old should be kept out of direct sunlight. Their skin contains too little melanin, the pigment that provides some protection from the sun.
• Sunscreen is not recommended for babies less than 6 months of age — shade, clothing and hats are best.
• Babies older than 6 months should also be kept out of the sun as much as possible, particularly in summer when the sun is at its strongest. If you go out when it’s hot, attach a parasol or sunshade to your pram or stroller to keep them out of direct sunlight.
• Cover your baby’s body, arms and legs with clothing, and make sure you use a sunhat with a wide brim or a long flap at the back to protect their head and neck from the sun.

Feeding your baby

Like adults, babies need to drink plenty of fluids to avoid becoming dehydrated. You know your baby is hydrated if there are 6 to 8 pale wet nappies a day.

For the first 6 months, when your baby is only having breast milk or formula, you should not give them any water. During hot weather, you may find your baby wants to feed more often but for shorter periods.

Car travel

If you need to travel by car in hot weather, try to make the trip during the coolest part of the day, which is usually early morning.

Make sure your baby is in the shade while travelling and keep the car cool using air conditioning or by opening the windows. Remember to never leave a baby alone in a parked car.

Dehydration

To prevent dehydration:

• keep your baby cool
• give your baby extra breastfeeds or formula if they are bottle-feeding
• dress your baby in a nappy only
• keep your baby out of the sun

Take your baby to the doctor if he/she:

• has less than six wet nappies a day and/or urine (wee) that is dark-coloured and strong smelling
• is lethargic (tired, sleepy and not active)
• has dry skin and mouth
• feels hot and dry to touch

For more information see Babies in hot weather.

Babies who are not feeding well, who appear weak or sick, or who are vomiting or have diarrhoea, should be taken to a doctor immediately.

Before you go home, you will get an Australian Government Parent Pack. This pack contains instructions, plus:

• a form called “Newborn Child Declaration”
• the Newborn/Child Claim for Family Assistance and Medicare form signed by your doctor or midwife. You must lodge this form within 26 weeks of your baby’s birth if you are claiming maternity payment or enrolling your baby in Medicare. Enquiries to the Family Assistance Office – 13 61 50.

You will also be asked to complete a Notification of Newborn Surname form and return it to staff. This enables us to keep up-to-date hospital records, so if your child returns for care in the future, medical records can easily be found.

This pack also contains links to assist you to go online and manage your claims, details and payments.

Australian Childhood Immunisation Register

It is important that your baby is registered with Medicare as soon as possible after birth so your baby will be on the immunisation register and can be seen by your GP for his/her two-week check.

Government payments

You may be eligible for one or more parenting payments. If so, you can start the claim process for some payments up to three months before you expect your baby to arrive.

For further information visit Having a baby - Services Australia.

Personal Health Record (Blue Book)

You will be given a Personal Health Record or Blue Book. This contains information about your baby’s birth and should be taken to all appointments.

Health providers will document information such as weight checks, feeding progress and immunisations. This record also contains information for parents on child development and immunisations.

Babies who are born prematurely, or who are sick at birth, may require care within our Special Care Nursery. This unit caters for babies born from approximately 31 weeks onwards.

When entering the Special Care Nursery, certain precautions are necessary to ensure that the babies are not placed at risk of infection – all visitors must wash their hands when entering the unit, and refrain from looking at or touching other babies.

Visiting hours

Parents are welcome to visit at any time and are encouraged to be present during the ward rounds to discuss their baby’s care with the staff.

Babies in this unit are supplied with clothes and nappies; however, you are welcome to provide your own.

For more information, please call the Special Care Nursery on (08) 8182 9101.

If your baby is in the Special Care Nursery and you wish to stay in hospital with them but you no longer require hospital care, boarder beds may be available. There is a fee attached to this service.

The usual length of stay for women following a normal birth is 24 hours and following a caesarean section it is 24 to 48 hours. Support is available from our home visiting midwives and mothercarers (if you choose to have their service).

Please see the fridge magnet poster you will get when you go home. Keep it handy so you can refer to it and call for assistance or advice if you are concerned about your health.

Contacts for you:

• Lyell McEwin Hospital Women’s Assessment Unit (for up to six weeks): (08) 8282 1303
• Your GP
• Healthdirect Australia: 1800 022 222 (24 hours a day)

Before you go home

Before you go home the midwives will give you a fridge magnet poster that contains important information about your baby’s health. Please read this and keep it on the fridge to refer to over the next few weeks. It contains detailed information about how to know if you or your baby are unwell and who to call.

Contacts for your baby:

• Call 000 for an ambulance in an emergency.
• Parent helpline on 1300 364 100.
• Your GP.
• Healthdirect Australia on 1800 022 222 (24 hours a day).

Post-natal check up

We recommend you visit your GP for a well‑baby check when your baby is two weeks old and you and your baby should both visit your GP when your baby is six weeks old.

If you do not have a regular GP, we recommend you seek one in your area. Make an appointment with your GP at any time following discharge from hospital if you are concerned about yourself or your baby.

Home Visiting Midwifery Service

The Home Visiting Midwifery Service consists of a team of midwives who provide post-natal and neonatal care in your home after discharge from hospital, seven days a week.

Please talk to the midwives before you go home about when you can expect your first visit; this is usually within 48 hours of discharge. Most women will receive between one and three home visits.

Ongoing breastfeeding support can be accessed through the Breastfeeding Day Unit or during mothercarer support. For more information, please contact the Home Visiting Midwives on (08) 8182 9252.

Your safety and wellbeing

• Before opening the door, ask the staff member attending your home to produce their identification badge and check the photograph is correct.
• We usually arrive in a government car.
• Never leave the doors unlocked for our staff.
• Request information or explanation from the midwife or mothercarer when you are unclear about any care being provided.
• Participate and give consent to all decisions regarding care, including referrals to other services.
• Do your best to be at home at the agreed time so care can be provided in a timely manner.
• Contact us if you would like to discuss any issues.

You have the right to:

• be informed of the processes available within the hospital to discuss and resolve complaints or concerns
• expect care of a safe standard that is considerate and respectful, and without discrimination
• be informed of other resources available to promote health and wellbeing
• confidentiality of your information and records (except when required by law, or when consent has been obtained from you for information to be provided to other service providers)
• withdraw from Lyell McEwin Hospital services at any time without retribution
• decline care in the presence of a student

For further information about your rights, see the Your Rights and Responsibilities booklet available at the hospital.

Staff safety and wellbeing

• Notify the staff member of anyone in your home, or your neighbours’ homes, who may be a threat to staff safety.
• Secure pets before the due arrival time.
• Ensure there is adequate lighting. Notify the staff member of any hazards that may cause tripping or slipping, and of any unsafe electrical equipment.
• If you or your family members smoke, please refrain from smoking inside whilst the service is being provided.

Please note, Lyell McEwin Hospital reserves the right to withdraw services or develop specific contracts of care where this is considered to be in the best interest of staff health, safety and wellbeing.

If a staff member perceives a threat to their safety, they may terminate the visit. If you are delayed and will not be home, please let us know as soon as possible.

Home Visiting Midwives:
(08) 8182 9252 (8:00 to 9:00 am or 3:00 to 4:30 pm)
(08) 8182 9380 (10:00 am to 3:00 pm – Ward Clerk, Women’s Health Ward)

Mothercarer service

Lyell McEwin Hospital is the only hospital in the state providing new mothers with support from mothercarers during their first week at home with their new baby.

The mothercarer service is free for all new mothers and their families, provided they live within a 45‑minute drive of the hospital and are discharged within 24 hours after a normal birth, or within 48 hours after a caesarean section.

The service provides up to four days of support in the home during the first week following birth, for approximately five hours per day (around 9:30am to 3:00pm). Your mothercarer will help you rest and relax so that you can bond with your baby.

Mothercarers are supported by, and work closely with, the Home Visiting Midwives and have received training in the health of mothers and babies following childbirth.

They can assist with bathing your baby, feeding and settling, caring for your baby, light household duties, and providing general help around the home.

The mothercarer service can provide information on:

• organising your baby’s bath
• nappy changing hints
• how to wrap your baby
• caring for your baby’s cord
• caring for your baby’s skin
• safe sleeping practices to reduce the risk of SIDS
• baby massage
• how to settle your baby
• support with breastfeeding
• assistance with expressing and storing breast milk
• support with bottle feeding
• hints on keeping your baby safe
• how to recognise your baby’s communication
• how to play with your baby

Increased relaxation and quality family time may include help with:

• cooking
• managing visitors
• child and/or baby minding
• entertaining other children
• answering the telephone and door while you rest
• assisting with filling out and submitting paperwork
• shopping and/or transport (on days when a car is available)
• help around the house with light house duties

Help as you prepare for the coming weeks:

• discussions on creating a routine
• provide information on community support services and programs
• help you to locate the best places to get what you need.
  

For further information about the Mothercarer service:
Call the Mothercarer office on (08) 8182 9729 or ask a midwife for an enrolment form.

Australian Breastfeeding Association (ABA)

We recommend you contact your local branch of the ABA for breastfeeding and parenting support. You can also join their association for further assistance and support groups.

Information is also available online via:
www.breastfeeding.asn.au

Child and Family Health Services (CaFHS) – Universal Home Visit

While you are in hospital, a midwife will check your contact details and seek your approval for a CaFHS nurse to visit you at home.

In most cases, you will receive a phone call from CaFHS at 1–4 weeks following discharge from the hospital and again around 6–8 weeks to offer you a home visit.

At this visit, a qualified child health nurse will check your baby, answer your questions and offer support.

If you have not received this call to arrange a visit, please call CaFHS on 1300 733 606.

CaFHS also provide services to newborns, infants and children until five years of age, including:

• health checks
• developmental screening and support with feeding
• behavioural issues, sleeping and settling

CaFHS services are free of charge and include new parent groups, support for new parents, a self-weighing service, and a 24‑hour Parent Helpline – 1300 364 100.

Online support is also available at:
www.cyh.com

My Health – Metropolitan Youth Health

My Health, Elizabeth can see any pregnant woman aged between 12 and 25 years for baby checks and contraception.

A paediatric registrar is usually available one day a week to provide these checks.

They also offer glucose tolerance testing and whooping cough and flu vaccinations if you choose to have them done at this service.

Helpful websites

• Australian Breastfeeding Association 
• Baby seats / child car restraints 
• Beyond Blue – depression and anxiety
• Black Dog Institute – better mental health
• Centre of Perinatal Excellence
• Centrelink 
• Child and Family Health Services 
• Continence 
• Department of Human Services
• Gidget Foundation – mental health support
• Immunisation
• Kidsafe 
• Medicare 
• Mum Space — mental health support for new mums
• Newborn hearing assessment t
• Newborn Screening Test 
• Parenting SA – parenting advice
• Perinatal Anxiety & Depression Australia (PANDA) 
• Pregnancy, Birth and Baby 
• Product safety
• Quitline — help to quit smoking
• Raising Children Network – parenting guide for all ages and stages
• Red Nose - safe sleep for baby 
• We Are Family – pets and children